Exploratory Clinical Study to Evaluate the Potential Bioactivity of CLBS14 in Patients with Coronary Microvascular Dysfunction Project Summary/Abstract CLBS14 is an autologous cell therapy consisting of G-CSF mobilized autologous CD34+ cells obtained from peripheral blood. The primary mode of action is improvement in perfusion by neo-angiogenesis and/or microvascular function under conditions of inadequate perfusion. The therapeutic focus of the proposed clinical study is coronary microvascular dysfunction (CMD), for which therapeutic strategies are limited. Approximately 20 subjects with CMD will be enrolled in the single arm study. The primary objective is to evaluate the potential bioactivity of intracoronary delivery of autologous CD34+ cells (CLBS14) in subjects with CMD and no obstructive coronary artery disease, as determined by invasive testing of coronary microvascular function as determined by assessment of coronary flow reserve (CFR). Additional data will be collected on endothelial-dependent microvascular function as determined by measurement of coronary blood flow in reaction to acetylcholine; endothelial-independent microvascular function as determined by measurement of coronary blood flow in reaction to adenosine; peripheral arterial tonometry; quality of life as measured with an angina diary, Seattle Angina Questionnaire (SAQ), and a health-related quality of life questionnaire; exercise tolerance as assessed by treadmill testing and by recording of daily activities with a Fitbit. The study is being designed and implemented by well-regarded investigators in CD34+ cell therapy and ischemic cardiac disease. Dr. Douglas Losordo from Caladrius Biosciences is the sponsor and study director and the investigators are Dr. Timothy Henry and Noel Bairey Merz of Cedars-Sinai Medical Center and Dr. Amir Lerman of the Mayo Clinic. Cedars-Sinai and Mayo Clinic are co investigators on the grant. Product manufacturing is provided by PCT, a Caladrius Company and a recognized leader in contract cell therapy manufacturing. For preparation of CLBS14, each patient is treated with G-CSF for up to 5 days to mobilize CD34+ cells from the bone marrow and into peripheral blood. Each patient undergoes apheresis to provide the starting material for manufacturing CLBS14. The apheresis material is processed to separate and enrich CD34+ cells, which are then formulated for administration back to the patient via intra-coronary infusion. Following infusion of CLBS14, patients are monitored for safety and efficacy endpoints for up to one year. It is expected that the trial will take approximately 2 years to complete. Results from the research will be presented in one or more public forums and published in a peer-reviewed journal. With the novel angiogenic mechanism of action of CLBS14 and specifically targeting coronary microvascular dysfunction to improve coronary microvascular flow responsible for the major adverse cardiac events and poor quality of life in this population, this project will be a strong contributor to NIH?s mission to develop new and effective therapies for underserved diseases. Caladrius Biosciences - Proprietary and Confidential